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Introduction: Children worldwide often do not drink enough. However, sufficient fluids are essential for physical and cognitive health. A regular and adequate supply of fluids also supports bladder maturation in the context of acquiring urinary continence. We investigated whether training preschool children and their caretakers improves drinking and micturition habits. Methods: This field study in a pre-post design was conducted in 6 kindergartens in the district of Garmisch-Partenkirchen from October 2018 to February 2019. An intervention group (IG) received a 3-day training on drinking and micturition habits and was compared to a control group (CG) without any training. Caretakers (IG + CG) were instructed about drinking and voiding management, too. Behavioral changes were identified by questionnaires. To analyze the long-term effect, group interviews were performed with the IG 3 months after training. The training was evaluated on different levels. Results: After training, the estimated total daily fluid intake in the IG (1,160 mL) significantly exceeded that of CG (830 mL) (p = 0.015). In the IG, fluid intake until 12:00 a.m. increased (p = 0.001), children took more time for voiding (p = 0.029), and urgency decreased (p = 0.008). Children (IG + CG) used leg support to enable pelvic floor relaxation more often both at home (p = 0.026) and in kindergarten (p = 0.047). Nocturnal enuresis was reduced by approximately 46% in the IG (p = 0.485). Group interviews in the IG showed a considerable learning effect. Conclusion: The present study could demonstrate an increased intake of fluids and significant changes in micturition behavior in the IG. So far, this is the first educational project in Germany addressing drinking and voiding management. Our results suggest that a training of preschool children and their caretakers is feasible and effective. Further nationwide research will be needed to confirm our results and assess the need for prevention in these areas. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has led to an unprecedented expansion of telemedicine services worldwide. This study aimed to explore the practice of telemedicine in Pediatric Surgery in Germany, the impact of the pandemic on its development and parents' and surgeons' experiences with telemedicine. Methods: The study is a cross-sectional analysis using three surveys between 6/2020 and 10/2020: (1) all Pediatric Surgery departments of Germany reported whether they provide telemedicine services. (2) Members of the German Society of Pediatric Surgery and (3) families who participated in an outpatient visit by telephone or video with the Department of Pediatric Surgery and Pediatric Urology of the University Hospital Frankfurt completed an anonymous survey on their experience with telemedicine. Results: 21% of the Pediatric Surgery departments in Germany provided telemedicine, of which 57% started due to the pandemic. The lack of physical examination and face-to-face contact seem to be the major limitations to surgeons and parents. 48% of the parents answered that telemedicine is equal to or better than traditional appointments, while 33% thought that telemedicine is worse. Conclusions: This study shows that families and doctors alike have had positive experiences with telemedicine and most will continue to use this format after the pandemic. [ABSTRACT FROM AUTHOR]

Aims: The Paediatric Urology Guidelines Panel reports initial experience with patient involvement in spina bifida patient groups to gather information on their awareness of the guidelines and reflection of guideline recommendations. Methods: The survey was delivered to spina bifida patients/parents via the national society groups in Turkey, Germany, and The Netherlands. Questions included demographic features, medical status, awareness, and agreement on the recommendations given in the guidelines and future expectations. Results: A total of 291 patients from 3 countries responded to the survey. Mean age was 13.9 ± 12.2 years, male/female ratio 138/151, 75% of all surveys were completed by the caregivers. The medication was taken by 78% of patients (64% anticholinergics). Complete dryness rates for urine and stool were 24% and 47%, respectively. The agreement rates on the recommendations regarding urodynamics, intermittent catheterization, anticholinergics drug use, bowel management, and life‐long follow‐up were 97%, 82%, 91%, 77%, and 98%, respectively. Only 8% of responders were aware of the European Association of Urology/European Society for Pediatric Urology guidelines. The priorities of patients for future expectations were as the following: quality of life (QoL), surgical techniques, development of new medications and sexuality/fertility issues. Male spina bifida patients preferred new medications and sex/fertility issues more, whereas females favored QoL issues improvement more. Conclusions: Although the native language of the involved patients was different from English, awareness of guidelines was 8%. The general approval of the recommendations given in the guidelines is quite high. The national society groups showed a great interest to get involved in the creation of the guidelines to improve health care for spina bifida patients. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated health related quality of life of pediatric patients with nonneurogenic urinary incontinence and determined potential influencing factors. Also, health related quality of life results in our sample were compared to those of other chronic childhood health conditions. Materials and Methods: This cross-sectional study was done at 3 tertiary referral centers for childhood urinary incontinence. From July 2007 to April 2008 we consecutively evaluated 65 boys and 38 girls with a mean ± SD age of 9.3 ± 2.2 years (range 6 to 18) and their parents. Of the patients 12 had monosymptomatic enuresis, 79 had nonmonosymptomatic enuresis and 12 had isolated daytime incontinence. To evaluate participants we used the self-reported and proxy versions of the 10-item DISABKIDS chronic generic measure, short version, a health related quality of life questionnaire with cross-cultural validity. Results: Mean questionnaire total scores were 43.2 and 42.8 for the self-reported and proxy versions, respectively, which showed significant correlation (r = 0.628). Age, sex, urinary incontinence type and severity, fecal incontinence and constipation had no significant association with questionnaire total scores (each p >0.05). Compared to questionnaire results in a reference sample of children with chronic health conditions average scores in our sample did not differ significantly from those in pediatric patients with asthma, arthritis, atopic dermatitis, cystic fibrosis, diabetes or epilepsy on the self-reported version, and asthma, atopic dermatitis, cystic fibrosis or epilepsy in the proxy version. Conclusions: Health related quality of life of children and adolescents with urinary incontinence appears to be comparable to that in pediatric patients with other chronic conditions, eg asthma or epilepsy. [Copyright &y& Elsevier]

Purpose: We translated and cross-culturally adapted the English version of the Pediatric Incontinence Questionnaire, and tested the reliability and validity of the German version. Materials and Methods: This cross-sectional study was done at 3 tertiary referral centers for childhood urinary incontinence. The self-reported and proxy English version was translated and cross-culturally adapted. From July 2007 to April 2008 we evaluated the German version in 91 boys and 54 girls with a mean ± SD age of 9.3 ± 2.2 years (range 6 to 18) with nonneurogenic urinary incontinence and in their parents. For concurrent criterion related validity, the German questionnaire scales were compared with those of the DCGM-10/-12. Results: On reliability testing of the self-reported and proxy German versions Cronbach''s α was 0.84 and 0.86, respectively. Interrater convergence between the self-reported and proxy versions showed an ICC of 0.81. Reproducibility was satisfactory for the self-reported and proxy versions (ICC 0.77, 95% CI 0.77–0.90 and 0.85, 95% CI 0.67–0.84, respectively). German version scores correlated with DCGM-10/-12 scores (self-report and proxy r = −0.71 and −0.69, respectively). Mean German version total scores were 23.0 in boys and 23.9 in girls. Except for a slight significant association between age and German version total score in the proxy version (p = 0.01), age, sex and incontinence type or severity (number of wet days/nights per 14 days) were not significantly associated with German version total scores. Conclusions: The German version of the Pediatric Incontinence Questionnaire is a valid and reliable outcome measure to assess health related quality of life in children and adolescents with urinary incontinence. [Copyright &y& Elsevier]